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Case Reports
Postprandial Dizziness/Syncope Relieved by Alfa-Glucosidase Inhibitor: A Case Report
Hakyeu An, Seong-Hae Jeong, Hyun Jin Kim, Eun Hee Sohn, Ae Young Lee, Jae Moon Kim
Res Vestib Sci. 2018;17(2):67-70.   Published online June 15, 2018
DOI: https://doi.org/10.21790/rvs.2018.17.2.67
  • 5,978 View
  • 119 Download
AbstractAbstract PDF
A 74-year-old man presented with positional vertigo and prandial dizziness and syncope. He had experienced episodes of frequent dizziness and loss of consciousness for several months. He underwent total gastrectomy with esophagojejunostomy and brown anastomosis 30 years ago. Thirteen years ago, subtotal colectomy with ileo-descending colostomy was done due to colon cancer. And he also had mitral valve replacement and maze operation due to severe mitral valve stenosis and atrial fibrillation. After cardiac operation, he has suffered from sudden dizziness with diaphoresis and chalky face, which usually occurs especially within 30 minutes from the onset of eating. Sometimes, this event was followed by several seconds of loss of consciousness, which caused recurrent events of falling. Neurological examination showed positional nystagmus compatible with benign paroxysmal positional vertigo arising from posterior semicircular canal of the right ear. The positional vertigo disappeared immediately after canalith repositioning maneuver. We tried to monitor vital signs and serum level of glucose during eating. Hyperglycemia (range, 210–466 mg/dL) was noted during eating, which was accompanied by postprandial and prandial hypotension, up to 60/40 mmHg. The patient was prescribed 100 mg of the alfa-glucosidase, acarbose to be taken half an hour before each meal. Eventually, the treatment with acarbose ameliorated the prandial dizziness and hypotension associated with hyperglycemia. Our patient suggests the acarbose could prevent postprandial dizziness and hypotension.
Gaze-Evoked and Perverted Head-Shaking Nystagmus in a Patient with Polycythemia Vera
Yong Soo Kim, Ik-Chan Song, Seong-Hae Jeong, Ae Young Lee, Jae Moon Kim
Res Vestib Sci. 2017;16(4):142-146.   Published online December 15, 2017
DOI: https://doi.org/10.21790/rvs.2017.16.4.142
  • 10,788 View
  • 140 Download
AbstractAbstract PDF
Polycythemia vera (PV) is well known chronic myeloproliferative neoplasm, caused by clonal expansion of an abnormal hematopoietic stem cell. Patients with PV may present diverse neurologic symptoms including headache, dizziness or vertigo, tinnitus. However, the attention has not been directed to the neurootological findings in patients with PV. Here, we present a 71-year-old male patient with PV suffered from vertigo and headache. He demonstrated gaze-evoked nystagmus and perverted head shaking nystagmus. Transcranial Doppler showed decrement of blood flow velocity in posterior circulation. The patient’s neuro-otologic findings were normalized as polychethemia and blood flow improved with repetitive phlebotomy and medications such as hydroxyurea and aspirin. Considering the neurological and hemodynamic findings in our patient, the mechanism of vertigo in PV could be explained by central vestibulopathy because of vascular insufficiency rather than peripheral vestibulopathy because of inner ear blood hyperviscosity.
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Gaze-evoked and Perverted Head-Shaking Nystagmus In a Patient with Polycythemia Vera
Yongsoo Kim, Ik-Chan Song, Seong-Hae Jeong, Ae Young Lee, Jae Moon Kim
Received November 8, 2017  Accepted November 27, 2017  Published online November 27, 2017  
   [Accepted]
  • 1,472 View
  • 0 Download
AbstractAbstract
Polycythemia vera (PV) is well known chronic myeloproliferative neoplasm, caused by clonal expansion of an abnormal hematopoietic stem cell. Patients with PV may present diverse neurologic symptoms including headache, dizziness or vertigo, tinnitus. However, the attention has not been directed to the neuro-otological findings in patients with PV. Here, we present a 71-year-old male patient with PV suffered from vertigo and headache. He demonstrated gaze-evoked nystagmus and perverted head shaking nystagmus. Transcranial Doppler showed decrement of blood flow velocity in posterior circulation. The patient’s neuro-otologic findings were normalized as polychethemia and blood flow improved with repetitive phlebotomy and medications such as hydroxyurea and aspirin. Considering the neurological and hemodynamic findings in our patient, the mechanism of vertigo in PV could be explained by central vestibulopathy because of vascular insufficiency rather than peripheral vestibulopathy because of inner ear blood hyperviscosity.
Original Article
Can Nitroglycerin Differentiate Benign Recurrent Vertigo From Vestibular Migraine? A Preliminary Study
Jong Wook Shin, Seong Hae Jeong, Ji Eun Oh, Ae Young Lee, Jae Moon Kim, Ji Soo Kim
Res Vestib Sci. 2012;11(1):8-13.
  • 1,743 View
  • 13 Download
AbstractAbstract PDF
Background and Objectives: Nitroglycerin (NTG), a donor of nitric oxide, is known to provoke migraine attacks in patients with migraine. However, this effect was not explored in patients with benign recurrent vertigo (BRV). To infer the mechanism of BRV, we evaluated provocative effects of NTG in patients with vestibular migraine (VM) and BRV compared with normal controls. Materials and Methods: Thirteen patients with recurrent vertigo, 8 with VM and 5 with BRV, and 5 healthy controls received intravenous infusion of 0.5 μg/kg/min NTG over 20 minutes. Headache intensity (visual analog scale) and associated symptoms were recorded at baseline and every 10 minutes for an hour. And the subjects were also asked to complete a headache diary every hour for another 12 hours. Results: In contrast to normal controls (2/5, 40%, p=0.035) and the patients with BRV (1/5, 20%, p=0.007), all patients with VM (8/8, 100%) had migraine attacks after NTG injection. However, there was no difference in the proportion of the patients with migraine attacks after NTG injection between normal controls and the patients with BRV. Conclusion: In contrast to the patients with VM, patients with BRV are not sensitive to nitric oxide. These results suggest that the pathophysiology of BRV may be different from that of VM.
Case Report
Acute Sensorineural Hearing Loss with Simultaneous Ipsilateral Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo: Report of a Case and Review of the Literature
Ji Hee Lee, Seong Hae Jeong, Eung Seok Oh, Eun Hee Sohn, Ae Young Lee, Jae Moon Kim
Res Vestib Sci. 2009;8(2):156-160.
  • 1,811 View
  • 10 Download
AbstractAbstract PDF
Benign paroxysmal positional vertigo (BPPV) originating from the posterior semicircular canal (pSCC) is a common vestibular disorder. Advanced age, head or ear trauma, other inner ear disorders, female sex and osteopenia/osteoporosis are known predisposing factors for pSCC BPPV. An association with simultaneous ipsilateral sudden deafness remains to be elucidated. We report a 62-year old woman with sudden deafness and simultaneous ipsilateral pSCC BPPV.

Res Vestib Sci : Research in Vestibular Science